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Countrymouse - I have brought it all up numerous times. He is nasty and defensive, but not hearing the words of her doctor or me. I would love to do more than slap him!! Heehee.
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Fedup, it's not just where mom is when she gets upset; she's reasoning with cognitive equipment of a 5 year old. We can SEE it when they're upset.

Keep on with the good fight!
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CentralMassach and Sandwich - I truly don't understand either of my siblings. One sister (passed away) had nothing to do with my Mom for 6 years or so because she couldn't deal with the dementia. How sad is that? I am done. I will have to send the letter and probably contact a lawyer. They have been mad at me because they truly thought I would have Mom live with me. NO! My adult son is still at home - he is severely (but stable) bipolar I from birth, to the point of being disabled by it. No way can I do this again. Their excuses besides from working full time are ridiculous. Thanks for the support and suggestions. This fight is not over by a long shot.
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I texted my brother yesterday morning about "his" decision" to extend the caregivier's time. I told him that it's just a bandaid covering a very bad situation. I told him I will get a lawyer involved if I have to. I asked once again if he truly sees the level she's at and her danger. I asked if the doctors words meant anything to him. I said he was a coward for not acting. I told him the definition of elder neglect. I told him that the state could come in and appoint a guardian for Mom. The first answer was a nasty - that I could just not help anymore and he would take care of her. Ha! And since when have I become such an expert. He would know all of these things if he bothered to do a little research! UGH! Very childish. I never received an answer to the second text. Incredible. We'll see. I take Mom to her doctor for a BP check on Tuesday. I will ask him if he can notify the authorities as well as me. My brother is cracking - maybe, hopefully, he will do the right thing by and for Mom after this "conversation".
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1. I hope you're saving all these text messages; they could be evidence if charges are brought for neglect.

2. I think your brother is showing the "I know how to do it better than you" attitude, which sometimes comes with people who are convinced they know more than you. And it's not just men; I know women who take this approach too....bossy know-it-alls.
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Yes - I've got them. Unless my phone goes wonky - the messages will be there. The thing is - he does little. He pops in in the evening to fix her dinner. He usually brings her something that is not very healthy and doesn't sit with her. I find it uneaten in the fridge or in the garbage. He did not take her to the ER when she fell at his house and was knocked unconscious for a bit. He took her home - I did not find out until 2 days later. He and my sister ignored the big, ugly skin cancer on her face - I am the one who did anything about it. So it is only in his head that he knows best. Pffft.....
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I emailed the elder attorney that has Mom's escrowed funds to begin the medicaid process. If I don't hear anything I will call. I just gave details about our situation. We'll see if they wish to do a consultation. Today is another day - we'll see what happens.

And, I figured out how to send my text messages to my computer! From now on, I'll have all of them.
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Well, that didn't make any sense! I emailed them about help with getting Mom placed vs. my hard-headed brother.
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Well, the SOB has taken control. I knew it would happen. He had the audacity to cancel Mom's doctor appointment tomorrow, most likely because she didn't want to go. He has, for now, turned her against me. She was already mad because I had the audacity to bring up thinking about moving to a home. He did, however, increase the caregiver days and time today. Not enough.

In a way ( awful isn't it?), I hope Mom falls and has to be hospitalized so that he will see the danger. The only difference is, with someone there if it happens, she won't lay there for hours before someone realizes. She could end up in the hospital with malnutrtion and/or dehydration because my siblings do not sit with her to make sure she eats and drinks, and mom tells the girl that she won't eat. UGH!! I have done all I can do. It will ALL be on him now.

I am taking the rest of my diary and a note letting her doctor know what's going on, and that it won't be me bringing her in. This will come back back to bite him in the butt. Now that he's increased caregiver time, I don't know that APS will do anything. But I am calling them anyway. Maybe they will see that she doesn't eat and she's still alone all night long. I emailed an attorney with a consultation request. I will have to call them as well. The situation is so bad - the increase is a bandaid. I am truly disgusted with my brother. My mom cannot make this decision - she doesn't even think she has dementia. There is nothing wrong with her except that she's old. I fear for her health and safety. She needs 24/7 care. We'll see.
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Thanks for the update. You're right, things are going to have to get worse before they get better. But remember this:you are not responsible for this tragedy in the making. If I were you, I'd back off and wait to see if the increase in aide hours works out. Maybe it will. Maybe it will be enough for mom to have someone there to encourage her to eat. Maybe she'll be sensible about not taking risks when no one is there.

Perhaps you and your siblings could pull together and work out a system where one of you calls each night to check on mom at bedtime. I think it would be great if the three of you could agree on something and regain a sense that you're all working FOR mom and not against each other.
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Bobalou - That would be great. Except that the damage was done when I said I could not have mom live with me. That's what they were assuming and counting on And then when I had to cut back my mom time for son time, they really got angry. So, it is what it is. My sister didn't even bother making arrangements to come to the family conferences - either one of them. She gives about an hour a week - if that. They both want to have their lives and not put in the mom time, but they expect it all to be okay. I am scared for Mom, but until something happens, it's not going to change. I am at least going to consult with a lawyer - maybe he/she can give me a direction to move on. I have covered my rear end as far as neglect and helping goes. Not sure if the doctor can do anything. I am saddened that my brother is kowtowing to her - he always has. The sad part is, he has seen everything I relay to him. But he's also the Dad who will not acknowledge that his youngest daughter has a severe mental illness. Denial is not a good place to be in. Thanks for the support.
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It sounds like there may be something wrong with your brother. Is he stable? Is he functioning in his own life? Something is not right with him. I would suspect there is something going on other than him just being stubborn.
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Sunnygirl - I guess he's stable. Unless this is about the little bit of money she has, I really can't figure out why he is doing this. I do think he has an outdated picture of nursing homes, and I do think he's afraid Mom will die quicker in a facility. She will die quicker at home the way things are! I am at a loss, especially since he was ready for me to go ahead with the placement. When I told him he had to fill out the paperwork and sign - it was an instant no way! Well, it's all on him now because I'm out. I'll give Mom a few days to forget, and then I'll visit her. She was wanting my key back last night. Heehee.
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Ah, Fedup, I see. There is a lot of assuming that goes on in your family, I see. Had you previously indicated that you would care for mom in your home, or was this an assumption on their part?

If I may be so bold: you are assuming that the doctor's appointment got cancelled because mom didn't want to go. How did you find out about the cancellation ? In your shoes, I would call brother and say, neutrally I hear mom's appointment for today is cancelled, is something up?

I've found over several years of dealing with my mom with vascular dementia, 1. Never believe anything mom tells me without independent verification and 2 never make assumptions about why something is happening, or not happening ( my brother isn't calling me back because he's mad, the nurse isn't calling me back because something is wrong, etc,). It's saved me a lot of heartache.
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Threats are just words and all the words in the world will not make your brother change his mine. You need to call APS now. the longer you wait the worse your mother is going to get. Your waiting could mean life of death for her if she falls and has an accident.
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I would call APS (and remember, it might not trigger anything more than a brief visit, a decision of "she's fine" and nothing more happens), JUST to assure yourself that you've done, and are doing the right thing. And covering yourself in case someone says "why didn't her daughter..."

And just as a bit of sympathy for your brother, remember that he can't make her move. She hasn't been declared incompetent and while the doctor thinks she should be in care, that doesn't compel her to go. Unless one of you has guardianship over her person, you can't compel her to do anything. So understand that that's a bind your brother is in.

When I realized that my mom should no longer live alone, I told " mom, I can't do this anymore (the endless trips an hour each way because she was upset about something) and told her that my brother (favorite child) was going to have a heart attack from racing to her home to rescue her from imaginary emergencies. My point is, ultimately, your mom is going to have to be convinced to move to AL. Unless of course she falls, ends up in rehab and then a nursing home. "Mom, if you go now, you have a choice about where you go. If you wait, maybe not so much".
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Babalou - He texted me last night about the appointment and the longer care hours. He had no right to cancel that appointment! I am certain it's because she didn't want to go. She had just been to the surgeon last week. He did not read the discharge papers - the appt. was for BP and low blood oxygen.

I have had that conversation with my mother many times. I even told her that we kids could be in serious trouble if she hurt herself and the hospital, or whoever, called in the authorities. If no one talks to her about it, she won't think about it.

I never, ever said Mom would live with me - that was their assumption because I was doing most of the grunt work. Because I already had the delightful experience of caring for my son, and mom and stepdad. He is early onset bipolar disorder and has had severe symptoms from birth. I have been a caregiver for 27 years!! That is where their assumption came from.

My brother is aiding and abetting her delusions that she is perfectly fine on her own. He tells her that I'm exaggerating her symptoms. No one wants to move to a nursing home, not be independent anymore, but sometimes it's necessary. None of us are medically, emotionally, or financially able to care for a dementia patient - mother or not. I am not physically able to lift her or do heavy cleaning. He does everything for her - I at least make her do things she can still do. Hang her shirts, dust - little things like that. That was per doctor's orders.

She is not totally "gone" yet, but she is not totally here, either. Some days are really bad. Some so-so. She is in decline. I always double check on things she says - most things I can verify, some I can't. Those I don't pay much attention to. Well, we'll see it all plays out. That's all I can do. If the shoe is on the other foot, maybe he'll see the need. But, yep, I am calling APS, and I know that they may not do anything, but at least it might scare them a little. Thanks.
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Fedup, do call APS, but call them for advice - rather than to file a report - and listen to what they say.

Let me explain what I'm thinking. It's about this bit - you're certain he cancelled the appointment because she didn't want to go. Well, now. Hold on a minute. That is, if anything, the *only* valid reason *for* cancelling the appointment: that your mother wanted to cancel it.

Now I know it's more complicated than that. You or I would have the practical authority, as long-term caregivers, if we were doing the negotiations here, to say "bollocks, mother, you're going to that appointment and liking it." We would be in a position to overrule her on the grounds that we have taken responsibility for her welfare for a long time, and she'd give in. But, having taken over the actual hands-on bit only recently, your brother has yet to see his way to doing that kind of thing; he doesn't yet know when he mustn't take no for an answer. He has to catch up.

But he is catching up and, given that he gave that commitment to your mother when he accepted POA, that's a good thing. Give him a chance to get up to speed. It may be that the result will be that he will have a rapid change of heart and come to your point of view that your mother needs to be in care. Good result 1: your mother moves in to long term care. But it could be, possibly, that he will find a way to keep her at home; and if he is determined to do that, especially if that is what she wants and continues to want, then good luck to him. If that is the outcome your mother wants, then that is what he should ideally be aiming for. It'll be rough on him, I doubt if he yet appreciates how hard the going will be; but if he is prepared to see it through...

I did three years of 24/7 home care for a vascular dementia parent and it wasn't pretty. Does he understand what he's wishing for?
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Countrymouse - the appontment was for her increased blood pressure and low blood oxygen. The surgeon requested that she go to her doc for a check. My stupid brother did not read the discharge papers. He thought the appointment was for a check to see if she was healing. I even told him that it was for BP. He cancelled the appointment because Mom did not want to go. She had been to the surgeon a few days before. Mom does not want to leave the house for anything. It took me 3 months to get her to get her hair cut.

I have given him many chances to "get up to speed". He has seen all of the behaviors and episodes. We have been going "round and "round for a year with this. He has totally disregarded what the doctor said - he doesn't even sit with her while she eats. That was made very clear during both of the conferences with the doc. He will get what he wished for. It won't take too long for Mom to have another bad spell or another fall. So I will let him take it all on.
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Ultimately, your mom is the one driving this train wreck. It doesn't sound like your brother has any sense of how to talk her into things.
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How low was mom's blood oxygen? Having low O2 can certainly interfere with clear headed thinking. Does your brother realize this? Does she have COPD or other lung disease?

I think I might call mom's doctor and report why the surgeon wanted her seen and the doctor's advice about what to do. Perhaps he could order nursing services to come out and see mom ever week or so, since she hates going out so much.

If she wants to stay in her home, she needs to accept in home care. Your choice mom.
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Nope! He really doesn't have much sense. He has made some really bad decisions that have gotten him into some very hot water over the years! Mom plays him like a fiddle. She has even played us against each other to get what she wants. Not as much now as in the early years of her DX. He has always kowtowed to her. He does not like confrontation or conflict. It's easier for him to give in to her than possibly upset both of them. He will have to learn very quickly how not to let her run the show. I am able to do it from dealing with my son all these years, and I applied that knowledge to her. I do understand that part. But, he is ultimately hurting Mom and himself with his learning curve. His comfort level should not play a part in the care Mom truly needs.

To disregard what the doctor says and any healthcare professional who comes in contact with Mom is irresponsible. Anyone who sees her can very plainly see where she is at and what her issue is. I have a sneaking suspicion that the hospital mentioned something to him because he extended the aide help very quickly after fighting me on it for so long. He has got to open his eyes before something bad happens.
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Not taking her to that appointment could be construed as medical neglect. Which is why I would call the doctor to check out what s/he wants done about the symptoms your mom is demonstrating. A stroke would be a devastating event.
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The papers didn't say what the oxygen was. At the time of release her BP was normal. I think it was from the trauma of the surgery. Her blood pressure has been really good, maybe a bit low at times(needs to be a bit higher for dementia patients). She had just been to her doc about a week before the surgery for that very thing, plus her dementia check. She was also at a dermatologist and the surgeon's office prior to the outpatient surgery. That's most likely why he wanted it. To be certain. At the surgeon last week, her BP was normal as well. The point is, my a-hole brother should not have cancelled any appointment without checking with me first. If he had listened when i told him, he would have known what it was for. Had he bothered to read the discharge papers, he would have known what it was for. He was just being a butt! It wasn't right when the surgeon said it should be because I could not get an appointment that quickly. And told him she didn't want to go - of that I am positive. Mom has had visiting nurses and therapy many times - a condition of discharge. We have been through it all at one time or another in the last 6 years or so. If I notice anything - she's right in the doc's office - I do not hesitate. Whether she likes it or not. I have dealt with 5 year olds for a while now. Between my two boys and her! LOL.
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So, did you call APS?
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There are different types of facilities. Maybe your mom doesn't need nursing home care. What if she needs Assisted Living or Memory Care. A proper assessment could determine what type of facility she really needs.
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Bablou - No I did not call APS yet- too much going on. I was hardly home yesterday and today. Tomorrow morning before I take my son to the doc.

Sunnygirl - There are no assisted living facilities that take medicaid in my state. She will be self pay for less than a year, then will have to convert to medicaid. I have done my research - tons of it - months of it.- toured several places. The place I really liked has a very good dementia program. It is a rehab/long term care facility. Theei therapy unit is a good one as well. They have 7 doctors on staff and tons on nurses around the clock. I had 8 places on my list. Most of the places I toured put dementia patients that will convert sooner than later into double rooms right off the bat. That way they don't have to move and there is less confusion. I appreciate your suggestions - I really do, but I truly have done my homework on this issue. This situation is just going to have to play out. He has control, so he can face the fallout from that control. Her doctor is aware that my brother has shut me out. He is aware that he will be bringing her in now. So thanks for all of your help my friends. It helped just venting and ranting and explaining things.
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The place is also smallish - no more than 104 beds total. Some of the ones here have upwards of 250 -300. Not for me. Some are too hospitaly - I didn't like those. Some rooms are too teeny - this place had lovely, bright, sunny, good sized rooms with lots of storage. lots of places to walk outside, etc. She will be fine once she gets over her "mad" . It took my MIL about 2 months to become at home in her place.
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Good luck my dear. I'm glad you made her doctor aware. Let us know how things get on.
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Thanks. I am awaiting a call back from the APS person. She will probably call back when I'm on the road between here and there - it's going to be another one of those days. That's how it usually goes. Then I play phone tag for a day. I said I didn't want to file a report just yet, that my brother has shut me out of her care, and I am very afraid for Mom and I need some information and advice on the process. We'll see. I hope that (maybe) her doctor will see some form of neglect/ psych abuse that he is obligated(in my state) to report as well.
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